Risk Factors of Severe Covid-19 in People With Multiple Sclerosis : A Systematic Review and Meta-Analysis Publisher Pubmed



Etemadifar M¹ ; Nouri H^{2, 3} ; Maracy MR⁴ ; Akhavan Sigari A² ; Salari M⁵ ; Blanco Y⁶ ; Sepulveda M⁶ ; Zabalza A⁷ ; Mahdavi S⁸ ; Baratian M⁸ ; Sedaghat N^{2, 3}
Source: Revue Neurologique Published:2022

Abstract

Objectives: To gather, synthesize, and meta-analyze data regarding the risk factors associated with a severe course of COVID-19 among patients with multiple sclerosis (pwMS). Methods: MEDLINE, Embase, Scopus, and WoS were searched in May 2021. Briefly, the eligibility criteria included: 1) studies assessing COVID-19 severity among adult pwMS; 2) definitive diagnoses or high clinical suspicion of COVID-19; 3) a categorization of COVID-19 severity into at least two categories; 4) quantitative effect size and precision measurements; and 5) English language; and 6) clear effect size/precision measures. internal validity of studies was assessed using the NIH Quality Assessment Tools. A list of possible risk factors was created based on the search results and was later used in extraction, synthesis, and meta-analysis of the data. Results: Thirteen studies were included in the syntheses. Outcome measures were either extracted from the papers, obtained from the primary researchers or calculated manually. The meta-analyses showed a significantly (P < 0.05) increased odds of a severe COVID-19 in pwMS with all of the assessed risk factors, except smoking and most DMTs. Conclusion: This study facilitates evidence-based risk/benefit assessments in practice. Older men with progressive MS on anti-CD20 therapies are more at risk of an unfortunate COVID-19 outcome. © 2021 Elsevier Masson SAS